摘要
目的:探讨24个月内疾病进展(POD24)对霍奇金淋巴瘤(Hodgkin lymphoma,HL)患者总生存期(overall survival,OS)的影响,比较POD24组和非POD24组的临床特征以及分析影响POD24的相关危险因素。方法:回顾性分析2004年1月—2021年8月徐州医科大学附属医院确诊为HL且经过正规治疗的98例患者,进行预后评估及临床特征分析。结果:共纳入患者98例。所有患者的中位OS和PFS分别为75.3(25.0~228.0)个月和60.0(2.0~192.0)个月。其中POD24组27例,该组的中位OS和中位PFS分别为52.0(25.0~160.0)个月和12.0(2.0~160.0)个月,非POD24组的中位OS和PFS分别为84.0(25.0~228.0)个月和70.0(20.0~192.0)个月。单因素分析显示POD24、白蛋白(<40 g/L)、血红蛋白(<100 g/L)、血清β2-微球蛋白(>2.366 mg/L)、IPI评分0~2分、初次化疗后的治疗反应、年龄>60岁以及美国东部肿瘤协作组(ECGO)体能状态(PS)评分0~1分为与总生存相关的不良预后因素。多因素分析提示POD24(P<0.001)、白蛋白(<40 g/L)(P=0.011)、年龄>60岁(P=0.022)以及初始治疗后疾病达缓解(P=0.005)有独立预后意义。本组资料显示,非POD24组初次化疗后病情缓解的患者为63例,POD24组13例,此外,POD24组与非POD24组Ann Arbor分期、IPI评分、β2-微球蛋白、ECOG PS评分等特征差异有统计学意义(P<0.05)。结论:POD24为HL患者OS的独立预后不良因素,Ann Arbor分期Ⅲ/Ⅳ期以及初次化疗后的病情未缓解的患者发生POD24比例更高,而IPI评分0~2分、ECOG评分0~1分的患者发生POD24的比例更低。
Objective To explore the effect of progression of disease within 24 months(POD24)on overall survival(OS)of Hodgkin lymphoma(HL),compare to the clinical characteristics between POD24 HL with non-POD24 HL patients,and analyze the related risk factors affecting POD24.Methods The patients with HL who were treated in the Affiliated Hospital of Xuzhou Medical University from January 2004 to August 2021 were retrospectively analyzed,and their prognosis and clinical characteristics were evaluated.Results A total of 98 patients with HL were included.The median OS and PFS of all patients were 75.3(25.0-228.0)months and 60.0(2.0-192.0)months,respectively.Among them,there were 27 patients in the POD24 group.The median OS and PFS of thePOD24 group were 52.0(25.0-160.0)months and 12.0(2.0-160.0)months,The median OS and PFS of the non-POD24 group were 84.0(25.0-228.0)months and 70.0(20.0-192.0)months respectively.Univariate analysis showed that POD24,albumin(<40 g/L),hemoglobin(<100 g/L),serumβ2 microglobulin(>2.366 mg/L),IPI score 0-2,treatment response after initial chemotherapy,age>60 years,and Eastern Cooperative Oncology Group(ECGO)physical status(PS)score 0-1 were adverse prognostic factors associated with overall survival(OS).Multivariate analysis showed that POD24(P<0.001),albumin(<40 g/L)(P=0.011),age>60 years(P=0.022)and remission after initial treatment(P=0.005)had independent prognostic significance.According to the data of this group,63 patients in the non-POD24 group had remission after initial chemotherapy,while only 13 patients in the POD24 group.In addition,there were significant differences in Ann Arbor staging,IPI score,serumβ2 microglobulin,and ECOG PS score between the POD24 group and the non-POD24 group(P<0.05).Conclusion POD24 is an independent poor prognostic factor for the OS of HL patients.The proportion of patients with Ann Arbor stageⅢ/Ⅳand unresponsive disease after initial chemotherapy was higher in the POD24 group,while patients with IPI score 0-2 and ECGO score 0-1 have a lower proportion o
作者
韩倩楠
胡瑾
陆丰艺
周欣悦
杨志琴
徐开林
陈伟
HAN Qiannan;HU Jin;LU Fengyi;ZHOU Xinyue;YANG Zhiqin;XU Kailin;CHEN Wei(Department of Hematology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,221002,China)
出处
《临床血液学杂志》
CAS
2024年第7期497-503,共7页
Journal of Clinical Hematology
基金
江苏省自然科学基金(No:BK20161177)
徐州医科大学附属医院发展基金(No:XYFY2021001)。
